Archive for the ‘Legal’ Category

Last month, ObamaCare had its day (or days) in court. The case … NFIB, et.al. vs. Kathleen Sebelius, et.al. will be the most celebrated Supreme Court cases in modern history.

The Supreme Court heard six hours of oral arguments over three days. That is unprecedented.

There are 26 states that are suing the federal government. That is unprecedented.

The Supreme Court’s decision will impact over twenty percent of the US economy. That is unprecedented.

But what happens if the Supreme Court does strike down all or part of ObamaCare? We better have “Plan B” ready to go.

We all know that our healthcare system is broken. However, we can’t all seem to agree on how we reform or transform our healthcare system. Here is my short list of those things that the Congress should consider if the Supreme Court strikes all or part of ObamaCare:

• Make significant changes to the way we litigate medical professional liability cases. Physicians today order too many tests, prescribe …

Continue reading NFIB vs Sebelius: The Supreme Court and ObamaCare »

There’s been a great deal of debate regarding mergers in healthcare. For regional or smaller community hospitals, their viability in many cases may depend heavily on larger economies of scale. What about doctors, physician practices and outpatient centers?  From a lender’s perspective, there is definitely strength in numbers!  

As shrinking reimbursement becomes the 800 pound gorilla for all healthcare providers, we have to look towards improving efficiencies to survive. From throughput and case management to materials management and contract negotiations, providers have to find ways to improve across the board and cut waste within their existing processes. On top of improved efficiencies, they have to continually drive volume growth.   Procedure rooms with the lights off during operating hours at an ASC are critical dollars missed.  On one side of town there’s a patient waiting 3 days or more for a scan and on the other side of town there’s a CT sitting idle. 

Single …

Continue reading STRENGTH IN NUMBERS »

Since its passage, President Obama’s federal health reform has resulted in a series of unintended consequences. Just last week, the Kaiser Family Foundation released a study which indicates that ObamaCare has caused annual family health insurance premiums to increase at a rate three times higher than in 2010.

ObamaCare has created way too many unintended consequences. 

Remember the ObamaCare provision which guaranteed issue of health insurance for children?  It was intended to ensure that kids who were sick or had pre-existing conditions could obtain health coverage. However, the unintended consequence?  Many health insurers made the business decision to no longer offer so-called “children only” health insurance policies and thousands of children no longer have access to coverage in their state.

Remember how federal health reform was supposed to reduce overall costs? When ObamaCare was passed by Congress and signed by President Obama, the price tag was just over $800 …

Continue reading ObamaCare: More Unintended Consequences »

Consumers today need to take ownership understanding their physician’s motivation when they recommend surgery especially when it entails implantable products for surgical procedures such as a spinal fusion, knee or hip replacement. This motivation may be more than to help address a patient’s medical issue. It may also be a means for the physician to increase their personal income.

There is a growing trend in the healthcare industry that some physicians would not like consumers to know about. This trend is the development of physician owned distributors (PODs).  A physician owned distributor is a medical products supplier to hospitals that is partially owned by a physician or group of physicians. The primary role of the physician owned distributor is to provide products to its physician investors at the hospitals they practice medicine.

An example would be an orthopedic surgeon that performs hip and knee replacement surgery. This surgeon is an investor in the physician …

Continue reading Your physician’s business relationships may be hazardous to your health »

The American Recovery and Reinvestment Act of 2009 (“ARRA”) provided over $2 Billion Dollars in financial incentives to motivate hospitals and physicians (“Providers”) to adopt the Electronic Health Records (“EHR”).  The incentive money was designed to encourage Providers to purchase, adopt and more importantly implement the EHR to improve the overall quality of care, reduce medical errors and improve the clinical care coordination between Providers.  In order to ensure that Providers are using an EHR system to achieve these goals, the Providers are required to report on specific measures. 

The measures focus on (1) improving quality, safety, efficiencies and reducing health disparities, (2) engaging the patients, (3) improving care coordination among providers, (4) improving public health; and (5) ensuring privacy and security protections of patient information.  Upon achieving these measures, the Provider can attest to the government that they are a …

Continue reading Why is Meaningful Use Meaningful to Healthcare Providers »